Individual
MARY MALISSA ERRAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 S STATE ST, LINDON, UT 84042-1939
(801) 441-7144
Mailing address
20 S STATE ST, LINDON, UT 84042-1939
(385) 455-9146
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7829953-6009
UT
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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